Since 1993, the Washington Metropolitan WIHS (WMW) Consortium has enrolled and retained a representative community cohort of HIV-infected and uninfected women with the purpose of supporting NIAID in understanding the current epidemiology of HIV, risk behaviors, disease progression, treatment uptake and outcomes, and related co-morbidities. The early cohort of infected women is aging, and the effects of age and menopausal status on disease outcomes and co-morbidities is yet to be elucidated. The WMW has joined with centers around the country and with sites across metropolitan Washington, DC to address these issues. This is particularly pertinent as Washington, DC has the highest prevalence of HIV of any urban center in the U.S. and the WMW has enrolled and retained a cohort that represents women both ethnically and psychosocially. The WMW has successfully participated in all elements of the WIHS protocol and has actively supported the infrastructure of the national WIHS. WMW investigators have participated in all of the major WIHS scientific initiatives. Additionally, with its rich data baseand local and national specimen repository, the WMW has supported local and national initiatives designed to understand the pathophysiology underlying co-morbidities. The WMW proposes to continue this work and to expand its research portfolio by continuing its strong collaborative relationship with the national WIHS in the area of protocol development, implementation, sub study participation, and identification of new initiatives. Additionally, for the next cycle of funing we have proposed new initiatives that include a telephone-based intervention for depression that will positively impact adherence and health behaviors with the goal of reducing community viral load. This intervention can easily be implemented in the larger DC community. We are expanding our local initiatives on HIV and HCV associated liver disease by engaging a team of researchers in exploring the host response, epigenetic factors, and protein glycosylation in liver disease and cancer. We will also continue and expand our investigations in organ specific morbidities associated with long-term survival in an aging population with the goal of reducing or preventing morbidity in the areas of vascular health, neurocognitive decline, and the vaginal immunologic response in aging. We will accomplish this by engaging with national and local investigators with proven expertise in these areas to further leverage the NIH investment in this important cohort of women. This will allow us to better define the status of women with HIV and bring to fruition the goals of an AIDS free generation and effective and sustainable treatment for those already infected.